Pore: Tomblin's leadership needed for DHHR changes

CHARLESTON, W.Va. -- It will take strong leadership from Gov. Earl Ray Tomblin to make improvements at the West Virginia Department of Health and Human Resources, said Renate Pore, director of health-care policy for West Virginians for Affordable Health Care.

"I think people are crying out for this kind of leadership from the governor," Pore said.

Some state legislators also are ready to tackle problems at the DHHR.

Pore said West Virginia's governors have always been "afraid" of health care. Governors' staffs have not had people who have understood health care well, she said.

"[It's a tough] issue," Pore said, "but given how much money we spend on health care, there really ought to be an effort at the top level to manage it."

Tomblin's office recently released a report from a $320,000 audit of the DHHR by the Pennsylvania-based consulting company Public Works LLC. The report lays out 78 recommendations that auditors say would allow the department to save or gain $56.7 million in one year.

A spokeswoman for Tomblin said there is a "lack of legislative action needed to implement the recommendations in the report."

That's right, said Delegate Don Perdue, who co-chairs the Legislative Oversight Commission on Health and Human Resources. Most of what Perdue, D-Wayne, saw on a first reading of the report is recommendations the governor can implement.

The Legislature will have a role in the changes, too, he said. The Legislature ultimately is responsible for finding a way to fund programs, he said.

"It's important for us to understand how those programs are working, if they're working and how we might be able to benefit those programs by being engaged in some way," Perdue said.

Sen. Ron Stollings, who co-chairs the oversight panel with Perdue, said he stands ready to introduce legislation, if needed.

"Hopefully, we can work with the Governor's Office in a cooperative fashion," said Stollings, D-Boone.

Pore called the department's turnover rate "shocking." The staff is in charge of "enormous" amounts of money and needs strong, professional leaders who know what they're doing, she said.

"These jobs that people have at [the] DHHR are really big jobs that require very sophisticated, educated and thinking people and a long time to understand these systems," she said. Having a 30-percent turnover rate and no plan to replace leaders who retire is a real problem, she said.

In addition to leadership, Pore said, DHHR employees need respect from the Governor's Office on down.

"In my experience, governors have thought that [the] DHHR was a pain to be endured," she said. "We need the governor to respect the work that [the] DHHR does -- and the public, too."

Pore said she also is concerned with the understaffing at the DHHR, particularly at the Bureau for Medical Services.

According to the audit, the BMS, which administers the federal Medicaid program, has 62 filled full-time positions out of an available 100 slots. Those 62 employees oversee the day-to-day operations of a $3 billion program, auditors said.

"We have pointed this out for a long time: The DHHR, and especially Medicaid, is very understaffed," Pore said.

Tomblin has not yet announced if West Virginia will expand its Medicaid program to those who make up to 138 percent of the federal poverty level, as is an option under the Affordable Care Act. The governor has been waiting on the results of an actuarial study about the costs of expansion.

Advocates say that will mean about 120,000 uninsured West Virginians would qualify for coverage under Medicaid.

Pore said the Medicaid program should have three to four deputy commissioners with expertise in each of the programs Medicaid has, for instance long-term care, children and people with disabilities.

Pore said the WVAHC will use the auditors' report to advocate for change at the DHHR beginning next year.

"We can't go on the way we are," she said. "We desperately need change."